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At least 19 recordsLinked to original sources
PubMed1986

Diagnostic validity of the Vabra Curettage. Compared study on 172 patients who underwent Vabra Curettage and the fractional curettage of the uterine cavity.

The authors report 172 cases of patients who had to undergo a curettage of the uterine cavity and an endometrial sampling with Vabra Curettage. In 80.8% of the cases, the histologic diagnosis of the material removed with Vabra Curettage was comparable with that of the uterine curettage. In 8.7% of the sampling, the histologic diagnosis of the tissue removed with the "suction technique" was easier. In 10.5% of the cases, the diagnosis was more reliable in the samplings taken away with uterine curettage. In this last group, nevertheless, the endometrial tissue removed with Vabra curettage allowed us to exclude the presence of an adenocarcinoma or of an atypical hyperplasia. Only in 1.2% of the specimens, the Vabra Curettage did not allow us to exclude an endometrial pathology (for lack of material). On account of the increased incidence of endometrial carcinoma, the tolerability of the method proposed, its low cost, the Authors advocate a large-scale use of this method for a prevention program directed at the high-risk population for this carcinoma.

Adenocarcinoma↗
PubMed1985

Office hysteroscopy and suction curettage: can we eliminate the hospital diagnostic dilatation and curettage?

The hospital diagnostic dilatation and curettage is the most widely used method in investigating abnormal uterine bleeding. This procedure is expensive and inconvenient and poses some surgical and anesthetic risks. As an alternative to hospital dilatation and curettage, the procedure of office hysteroscopy and suction curettage was evaluated in 406 patients. The indications for the procedure are similar to the classic indications for a diagnostic dilatation and curettage. The method is convenient, safe, and relatively inexpensive. The diagnostic accuracy of office hysteroscopy and suction curettage surpasses prior reports of the accuracy of diagnostic dilatation and curettage. Office hysteroscopy and suction curettage should be the method of choice in the evaluation of abnormal uterine bleeding.

Adult↗
PubMed1991

Suction curettage with a tissue trap compared with sharp curettage for tissue sampling.

Recent reports have shown that various endometrial sampling techniques are comparable to each other. This study showed that suction curettage utilizing tissue traps is superior to sharp curettage in terms of adequacy of sampling. The results show that adequate tissue was obtained in all 114 cases, regardless of which type of curettage was utilized first. However, when sharp curettage was the second procedure, only 43 of 57 procedures yielded adequate tissue, whereas when suction curettage was the second procedure, 56 of 57 procedures yielded adequate tissue. Suction curettage utilizing tissue traps was more thorough than sharp curettage.

Curettage↗
PubMed1988

Diagnostic accuracy of outpatient endocervical curettage using conventional and Vabra curettage of the cervix.

With the object of examining the diagnostic accuracy of and pain reaction to endocervical curettage (ECC) either by using a new instrument, Vabra mc cervix, or with a conventional 3 mm metal curette, 298 patients with histologically verified cervical intraepithelial neoplasia (CIN) or cytological suspicion have been involved in a consecutive prospective randomized trial. One hundred and forty-eight patients underwent curettage with the Vabra instrument (vabrasio) followed by conventional curettage; 150 underwent the same procedure, but in reverse order. In 114 patients, CIN was ascertained in one or both trials. Vabra mc cervix found normal histology in 23 of these patients (20%), whereas conventional curettage showed normal histology in 58 patients (51%). Quantitatively, Vabra mc cervix extracted significantly more tissue material than did conventional curettage. The pain intensity when using of Vabra mc cervix was less severe. The present study showed diagnostic accuracy of Vabra mc cervix to be 80% (95% confidence limits: 63.38-80.73), compared with 49% (95% confidence limits: 35.17-54.35) when using conventional curettage.

Ambulatory Surgical Procedures↗
PubMed2006

There is no role for uterine curettage in the contemporary diagnostic workup of women with a pregnancy of unknown location.

BACKGROUND: The aim of this study was to generate and evaluate a new protocol that defined non-viability in the pregnancy of unknown location (PUL) population and therefore ensured no viable intra-uterine pregnancy (IUP) would be interrupted if uterine curettage was performed. A secondary aim was to evaluate published biochemical criteria that define non-viability in a PUL population to establish if these criteria could result in inadvertent termination of pregnancy (TOP) if uterine curettage was performed. METHODS: All clinically stable women classified as having a PUL were included in this study. Protocol 1 was developed retrospectively based on data from 500 consecutive PULs. Using this protocol, no cases of viable IUPs would undergo uterine curettage and the potential for TOP was eliminated. This protocol was then validated prospectively on the data from a further 503 consecutive PULs. Results were then compared with three established criteria (Protocols 2-4) for the use of uterine curettage as a diagnostic tool to classify the location of PULs. Protocol 2 defined non-viability when the hCG ratio (hCG at 48 h/hCG at 0 h) was or=2000 U/l or when the initial serum hCG was <2000 U/l with a serum hCG rise of <35% over 48 h (hCG ratio<1.35); Protocol 4 advised uterine curettage with a serum hCG rise of <50% over 48 h (hCG ratio<1.50). The number of uterine curettages performed and viable IUPs that would have undergone an unplanned TOP were recorded for all protocols. RESULTS: A total of 12 572 consecutive women were scanned: 1003 (8.0%) women were classified as PULs. Training set consisted of 500 PULs: 278 (55.6%) failing PULs, 176 (35.2%) IUPs and 46 (9.2%) ectopic pregnancies (EPs). Test set consisted of 503 PULs: 255 (50.7%) failing PULs, 203 (40.4%) IUPs and 45 (9.0%) EPs. Protocol 1 when developed retrospectively on the training set would have resulted in 293 uterine curettages and no potential TOP. Protocol 1 tested prospectively on 503 PULs would have resulted in 272 uterine curettages and no potential TOP. Three established criteria were tested on the entire data set (n=1003). Protocol 2 would have resulted in 114 uterine curettages and 14 (12.3%) potential TOPs; Protocol 3 would have led to 611 uterine curettages and seven (1.2%) potential TOPs; Protocol 4 would have resulted in 617 uterine curettages and three (0.5%) potential TOPs. No harm came to the women whose EP diagnosis was delayed. CONCLUSIONS: Established criteria for the use of uterine curettage in the management of PULs, including those advocated by the American Society for Reproductive Medicine (ASRM), can theoretically result in an inadvertent TOPs. On the basis of these data, a change in contemporary clinical practice should be considered to avoid further damage to wanted pregnancies. We conclude that uterine curettage should not be used in the routine diagnostic workup of women with a PUL.

Abortion, Spontaneous↗
PubMed2001

Curettage after mifepristone-induced abortion: frequency, timing, and indications.

OBJECTIVE: To characterize women who underwent curettage after medical abortion with mifepristone and vaginal misoprostol, to describe when curettage occurred and the reasons for the intervention, and to categorize the indications for curettage according to a simple classification schema. METHODS: These analyses used data from two multisite, randomized controlled trials sponsored by Abortion Rights Mobilization. In the first study, women pregnant less than 63 days received 200 mg of mifepristone and 800 microg of vaginal misoprostol to use 48 hours after taking mifepristone. In the second study, women pregnant less than 56 days were randomly assigned to insert vaginal misoprostol at 1, 2, or 3 days after mifepristone administration. Case report forms and clinical case notes of all women who underwent curettage were examined. RESULTS: Of the 4393 women enrolled in both studies, 116 (2.6%, 95% confidence interval 2.1%, 3.1%) curettages were identified. The gestational age and a history of prior elective abortion were associated with the rate of curettage. The distribution of indications for curettage included bleeding, 61 (53%); continuing pregnancy, 17 (15%); patient request, 36 (31%); and indeterminate, 2 (1.7%). The timing of curettage differed by the indication and scheduled interval between study visits. The distribution of the timing was bimodal. One subset of women, 44 (38%), underwent curettage in the first study week and another subset, 43 (37%), during weeks 3-5. CONCLUSION: Curettage after medical abortion with mifepristone and vaginal misoprostol is rare. At least one half of the curettages were performed for persistent bleeding several weeks after treatment. Both acute heavy bleeding and continuing pregnancy are extremely rare.

Abortifacient Agents, Nonsteroidal↗
PubMed1999

Uterine curettage following second trimester abortion by extraovular instillation of prostaglandin E2. A prospective-randomized trial.

OBJECTIVE: To evaluate the benefits associated with routine uterine curettage following complete second trimester termination of pregnancy by extraovular prostaglandin E2. STUDY DESIGN: Fifty-five patients between 15 and 24 weeks' gestation who had undergone complete termination of pregnancy by continuous extraovular instillation of prostaglandin E2 (PGE2), were randomly assigned into either no further intervention (n=25), or uterine curettage under general anesthesia (n=30). The need for late uterine curettage, clinical and ultrasonographic parameters at 1 and 42 days follow-up, as well as the incidence of the minor and major complications, were compared between groups. RESULTS: Baseline and post-abortion clinical and ultrasonographic characteristics were similar in both groups. Mean (+/- Standard error of the mean) number of post-abortion bleeding days in the curettage group was 8.9+/-1.8 versus 10.1+/-2.6 days in the non-curettage group (P=NS). No patient in the former group, compared to three patients in the latter group, needed late uterine curettage, (P=NS). Major and minor complications rates in the curettage and in the no-curettage groups were not significantly different. Considerably more patients in the curettage group needed analgesic agents following the abortion compared to the no-curettage group (60% vs. 3.3%, respectively; P<0.001). CONCLUSIONS: Routine uterine curettage in patients undergoing complete second trimester termination of pregnancy by extraovular instillation of PGE2, exerts no benefit.

Abortion, Induced↗
PubMed2006

The use of endocervical curettage in women with low-grade squamous intraepithelial lesions or atypical squamous cells of unknown significance on Pap smear.

OBJECTIVE: To determine the use of endocervical curettage in women with low-grade squamous intraepithelial lesions (LSIL) or atypical squamous cells of unknown significance (ASCUS) on Pap smear. METHODS: A cross-sectional study evaluated women at a single center colposcopy service between January 1999 and December 2003 having LSIL or ASCUS on Pap smear and compatible lesions on colposcopic examination who underwent endocervical curettage. Associations of abnormal endocervical curettage results with lesion topography, age, and satisfactory colposcopy were evaluated. A multivariate logistic regression model was used to evaluate independent associations and estimate the probabilities of abnormal endocervical curettage for different clinical scenarios. RESULTS: Two hundred thirty-seven women were included. The estimated prevalence of abnormal endocervical curettage was 5.5% (95% CI = 2.6%-8.3%). Only 2 endocervical curettage results reported cervical intraepithelial neoplasia 2 or 3 (0.8%, 95% CI = 0%-2%). Bivariate analysis showed a significant association between abnormal endocervical curettage result and central topography of the lesion (p = .01). A multivariate logistic regression analysis confirmed that association (p = .04). The model was used to calculate probabilities of abnormal results in different scenarios. CONCLUSIONS: The overall prevalence of abnormal endocervical curettage in patients with LSIL or ASCUS on Pap smear is low. The prevalence of endocervical curettage results reporting cervical intraepithelial neoplasia 2 or 3 lesions is even lower. Therefore, the use of systematic endocervical curettage performance in this setting is questionable. Our model helps to predict the probability of abnormal results and assist in the decision of whether to perform endocervical curettage.

Adolescent↗